Forms

Brochure (Download Below)

For additional information, please check out our FAQ page.

Parental Consent Waiver (Download Below)

If you are under 18 years of age, please have your parent or legal guardian complete this form, sign, and return to usajiujitsu.message@gmail.com.  This must be completed in order to process your membership.

Coverage Information (Download Below)

One of the many benefits members enjoy is Medical, Life, and Liability coverage through USA Jiu Jitsu, Inc.  Our coverage for each member is as follows:  $100,000 Medical ($250 Deductible) / $10,000 Life / $1Million Liability.

Insurance Claim Form (Download Below)

Please fill out the form in its entirety and forward to USA Jiu Jitsu by e-mail (usajiujitsu.message@gmail.com) or mail (P.O. Box 120085, Melbourne, FL 32912) within 72 hours of the injury occuring.  Be sure to provide a detailed description of the injury and how it occurred, as well as any potential witnesses (name and contact information), if possible.

*  DISCLAIMER(S)  *

Only injuries incurred at an advertised and legal event or a legal gym, dojo, academy, etc. will be covered.  (No backyard events or street fighting)

If a member is engaging in any illegal activity and a injury happens, it will not be covered.

At this time, accidents/injuries during MMA training is covered; however, accidents/injuries during MMA competitions are not covered.

USA Jiu Jitsu's insurance is a secondary coverage policy.  All other insurance policies carried by the member will be the primary coverage.  If a member does not have other insurance coverage, then our coverage will become primary.

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